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No Changes in Body Composition and Adherence to the Mediterranean Diet after a 12-Week Aerobic Training Intervention in Women with Systemic Lupus Erythematosus: The EJERCITA-LES Study.
Gavilán-Carrera, B, Ruiz-Cobo, A, Amaro-Gahete, FJ, Soriano-Maldonado, A, Vargas-Hitos, JA
Nutrients. 2023;(20)
Abstract
Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease linked to high cardiovascular risk. To reach an adequate body composition status while maintaining proper dietary habits are effective strategies for reducing cardiovascular risk, both being potentially modified through exercise. This study aimed to evaluate the effects of a 12-week aerobic training intervention on anthropometry, body composition and adherence to the Mediterranean diet in women with SLE. A total of 58 women with SLE were assigned to either an exercise group (EG; n = 26) or a comparison group (CG; n = 32) in this non-randomized controlled trial. The EG comprised 12 weeks of aerobic exercise (two sessions/week) between 40-75% of the individual's heart rate reserve (calculated as maximum heart rate - resting heart rate) and the CG received usual care. At baseline and after the intervention, the anthropometry (i.e., weight, waist circumference, waist-to-hip ratio, and body mass index) and body composition (i.e., fat mass and lean mass) were assessed using a stadiometer, an anthropometric tape, and a bioimpedance device, respectively. Dietary habits were assessed with the Mediterranean Diet score. There were no between-group differences in neither anthropometric nor body composition parameters (all p > 0.05). Similarly, no between-group differences were obtained in the adherence to the Mediterranean diet after the exercise intervention (all p > 0.05). Contrary to the initial hypothesis, these results suggest that the 12-week aerobic training intervention performed in this study did not improve anthropometry, body composition or adherence to the Mediterranean diet in women with SLE.
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Impact of a Comprehensive Intervention Bundle Including the Drug Burden Index on Deprescribing Anticholinergic and Sedative Drugs in Older Acute Inpatients: A Non-randomised Controlled Before-and-After Pilot Study.
Fujita, K, Hooper, P, Masnoon, N, Lo, S, Gnjidic, D, Etherton-Beer, C, Reeve, E, Magin, P, Bell, JS, Rockwood, K, et al
Drugs & aging. 2023;(7):633-642
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INTRODUCTION Implementation of the Drug Burden Index (DBI) as a risk assessment tool in clinical practice may facilitate deprescribing. OBJECTIVE The purpose of this study is to evaluate how a comprehensive intervention bundle using the DBI impacts (i) the proportion of older inpatients with at least one DBI-contributing medication stopped or dose reduced on discharge, compared with admission; and (ii) the changes in deprescribing of different DBI-contributing medication classes during hospitalisation. METHODS This before-and-after study was conducted in an Australian metropolitan tertiary referral hospital. Patients aged ≥ 75 years admitted to the acute aged care service for ≥ 48 h from December 2020 to October 2021 and prescribed DBI-contributing medication were included. During the control period, usual care was provided. During the intervention, access to the intervention bundle was added, including a clinician interface displaying DBI score in the electronic medical record. In a subsequent 'stewardship' period, a stewardship pharmacist used the bundle to provide clinicians with patient-specific recommendations on deprescribing of DBI-contributing medications. RESULTS Overall, 457 hospitalisations were included. The proportion of patients with at least one DBI-contributing medication stopped/reduced on discharge increased from 29.9% (control period) to 37.5% [intervention; adjusted risk difference (aRD) 6.5%, 95% confidence intervals (CI) -3.2 to 17.5%] and 43.1% (stewardship; aRD 12.1%, 95% CI 1.0-24.0%). The proportion of opioid prescriptions stopped/reduced rose from 17.9% during control to 45.7% during stewardship (p = 0.04). CONCLUSION Integrating a comprehensive intervention bundle and accompanying stewardship program is a promising strategy to facilitate deprescribing of sedative and anticholinergic medications in older inpatients.
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The acute effect of different NAD+ precursors included in the combined metabolic activators.
Li, X, Yang, H, Jin, H, Turkez, H, Ozturk, G, Doganay, HL, Zhang, C, Nielsen, J, Uhlén, M, Borén, J, et al
Free radical biology & medicine. 2023;:77-89
Abstract
NAD+ and glutathione precursors are currently used as metabolic modulators for improving the metabolic conditions associated with various human diseases, including non-alcoholic fatty liver disease, neurodegenerative diseases, mitochondrial myopathy, and age-induced diabetes. Here, we performed a one-day double blinded, placebo-controlled human clinical study to assess the safety and acute effects of six different Combined Metabolic Activators (CMAs) with 1 g of different NAD+ precursors based on global metabolomics analysis. Our integrative analysis showed that the NAD+ salvage pathway is the main source for boosting the NAD+ levels with the administration of CMAs without NAD+ precursors. We observed that incorporation of nicotinamide (Nam) in the CMAs can boost the NAD+ products, followed by niacin (NA), nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN), but not flush free niacin (FFN). In addition, the NA administration led to a flushing reaction, accompanied by decreased phospholipids and increased bilirubin and bilirubin derivatives, which could be potentially risky. In conclusion, this study provided a plasma metabolomic landscape of different CMA formulations, and proposed that CMAs with Nam, NMN as well as NR can be administered for boosting NAD+ levels to improve altered metabolic conditions.
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Efficacy of recombinant human interleukin-11 in preventing and treating oral mucositis after chemotherapy for patients with acute leukemia.
Zhang, Y, Li, Y, He, A, Wang, J, Zhang, P, Lei, B, Huang, Z, Zhang, L, Zhao, W, Ma, X
BMC oral health. 2023;(1):476
Abstract
OBJECTIVE This study aimed to investigate the clinical effects of recombinant human interleukin-11 (rhIL-11) gargle on preventing and treating oral mucositis (OM) after chemotherapy for acute leukemia. METHODS This single-site, prospective, observer-blinded, nonrandomized controlled trial was conducted on 74 patients with acute leukemia, who were divided into the experimental and control groups. The patients in the experimental group were treated with IL-11 gargle, and those in the control group were treated with sodium bicarbonate gargle. We examined the time and severity of oral mucositis, severity and duration of associated pain, healing time of mucositis, effects of OM on eating, and levels of T-cell subset indicators before and after treatment to evaluate the effects of IL-11 treatment. RESULTS The proportion of patients with severe OM was significantly lower in the experimental group than in the control group. Mucositis occurred later in the experimental group compared with the control group. The degree and duration of pain, ulcer healing time, and effects on eating were lower in the experimental group compared with the control group. Following treatment, the levels of all T-cell subset indicators improved in each of the two groups. However, the rate of improvement was significantly higher in the experimental group than in the control group. These differences were statistically significant (P < 0.05). CONCLUSIONS IL-11 gargle reduced the severity of OM after chemotherapy for acute leukemia. Treatment with IL-11 relieved pain, promoted healing, and improved the curative effect of the condition, making it worthy of clinical promotion.
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Effects of an urban forest healing program on cancer-related fatigue in cancer survivors.
Park, KH, Lee, H, Park, EY, Sung, JH, Song, MK, An, M, Bang, E, Baek, SY, Do, Y, Lee, S, et al
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2023;(1):4
Abstract
PURPOSE This study aimed to examine the effects of an eight-session structured urban forest healing program for cancer survivors with fatigue. BACKGROUND Cancer-related fatigue (CRF) is a complex and multifactorial common symptom among cancer survivors that limits quality of life (QoL). Although health benefits of forest healing on physiological, physical, and psychological aspect as well as on the immune system have been reported in many studies, there is limited evidence on the efficacy of specialized forest program for cancer survivors. METHOD A single-blinded, pre-test and post-test control group clinical trial was conducted with -75 cancer survivors assigned to either the forest healing group or the control group. The intervention was an eight-session structured urban forest program provided at two urban forests with easy accessibility. Each session consists of three or four major activities based on six forest healing elements such as landscape, phytoncides, anions, sounds, sunlight, and oxygen. Complete data of the treatment-adherent sample (≥ 6 sessions) was used to examine whether sociodemographic, clinical, physiological (respiratory function, muscle strength, balance, 6-min walking test) and psychological (distress, mood state, sleep quality, QoL) characteristics at baseline moderated the intervention effect on fatigue severity at 9 weeks. RESULTS Significant time-group interactions were observed muscle strength, balance, 6-min walking test, distress, fatigue, moods, and QoL. The mean difference in fatigue between pre- and post-forest healing program was 9.1 (95% CI 6.2 to 11.9), 11.9 (95% CI 7.6 to 16.1) in moods, and -93.9 (95% CI -123.9 to -64.0) in QoL, showing significant improvements in forest healing group, but no significant improvements in the control group. CONCLUSION This study suggests that a forest healing program positively impacts the lives of cancer survivors, by addressing both physical and psychological challenges associated with CRF. TRIAL REGISTRATION NUMBER KCT0008447 (Date of registration: May 19, 2023).
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High-protein diet with excess leucine prevents inactivity-induced insulin resistance in women.
Mangogna, A, Di Girolamo, FG, Fiotti, N, Vinci, P, Landolfo, M, Mearelli, F, Biolo, G
Clinical nutrition (Edinburgh, Scotland). 2023;(12):2578-2587
Abstract
BACKGROUND AND AIMS Muscle inactivity leads to muscle atrophy and insulin resistance. The branched-chain amino acid (BCAA) leucine interacts with the insulin signaling pathway to modulate glucose metabolism. We have tested the ability of a high-protein BCAA-enriched diet to prevent insulin resistance during long-term bed rest (BR). METHODS Stable isotopes were infused to determine glucose and protein kinetics in the postabsorptive state and during a hyperinsulinemic-euglycemic clamp in combination with amino acid infusion (Clamp + AA) before and at the end of 60 days of BR in two groups of healthy, young women receiving eucaloric diets containing 1 g of protein/kg per day (n = 8) or 1.45 g of protein/kg per day enriched with 0.15 g/kg per day of BCAAs (leucine/valine/isoleucine = 2/1/1) (n = 8). Body composition was determined by Dual X-ray Absorptiometry. RESULTS BR decreased lean body mass by 7.6 ± 0.3 % and 7.2 ± 0.8 % in the groups receiving conventional or high protein-BCAA diets, respectively. Fat mass was unchanged in both groups. At the end of BR, percent changes of insulin-mediated glucose uptake significantly (p = 0.01) decreased in the conventional diet group from 155 ± 23 % to 84 ± 10 % while did not change significantly in the high protein-BCAA diet group from 126 ± 20 % to 141 ± 27 % (BR effect, p = 0.32; BR/diet interaction, p = 0.01; Repeated Measures ANCOVA). In contrast, there were no BR/diet interactions on proteolysis and protein synthesis Clamp + AA changes in the conventional diet and the high protein-BCAA diet groups. CONCLUSION A high protein-BCAA enriched diet prevented inactivity-induced insulin resistance in healthy women.
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Does nutritional status influence the effects of a multicomponent exercise programme on body composition and physical fitness in older adults with limited physical function?
Moradell, A, Fernández-García, ÁI, Navarrete-Villanueva, D, Pérez-Gómez, J, Gesteiro, E, Ara Royo, I, Casajús, JA, Gómez-Cabello, A, Vicente-Rodríguez, G
European journal of sport science. 2023;(7):1375-1384
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Physical exercise effects and ageing on fitness may be influenced by nutritional status. This study investigates the effects of a 6-month multicomponent exercise training (MCT) on nutritional status and evaluates if this type of exercise could affect differently body composition and physical fitness depending on the nutritional status of older adults with decreased functional capacity. Ninety-three participants (80.4 ± 6.0 y) were divided into control (n = 45) and intervention (n = 48) groups. The intervention consisted of a 6-month multicomponent training. Comparisons between changes in body composition and fitness during the 6-months were performed between individuals at risk of malnutrition and those well-nourished, according to the Mini Nutritional Assessment. Model mixed-effect analyses were used to investigate differences after the 6 months of MCT between groups. Well-nourished participants compared with those at risk of malnutrition had higher: arm (13.4 ± 3.5 vs 14.3 ± 33.6 repetitions) and leg strength (9.0 ± 3.0 vs 11.1 ± 3.3 repetitions), maximum walking speed (31.6 ± 13.1 vs 23.7 ± 6.3s), agility (11.9 ± 5.8 vs 8.3 ± 2.1s), and aerobic capacity (31.6 ± 13.1 vs 23.7 ± 6.3 m), at baseline. After the training, those without risk of malnutrition in CON decreased their nutritional status (-1.7 + 0.7 points). Those well-nourished that performed the intervention decreased total fat mass (-1.0 ± 0.3 kg) and body fat percentage (-1.2 ± 0.4%). Both groups of training improved similarly in all tests, except for balance, in which the well-nourished showed improvements of 6.3 ± 1.9s. These results underline the usefulness of MCT in improving physical fitness regardless of nutritional status and preventing nutritional status detriment in well-nourished older adults, who are fitter and benefit more, in terms of body composition.Trial registration: ClinicalTrials.gov identifier: NCT03831841.Highlights Multicomponent exercise programme seems to be effective in delaying detriments in the nutritional status of well-nourished people.Well-nourished older people obtain more benefits in body composition from the multicomponent exercise than those at risk of malnutrition, decreasing adiposity.The positive effect of multicomponent exercise was observed in physical fitness independently of nutritional status.
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Can the supplementation of vitamin D, sun exposure, and isolation during the COVID-19 pandemic affect the seasonal concentration of 25(OH)D and selected blood parameters among young soccer players in a one-year training season?
Jastrzębska, J, Skalska, M, Radzimiński, Ł, López Sánchez, GF, Hill, L, Weiss, K, Knechtle, B
Journal of the International Society of Sports Nutrition. 2023;(1):2206802
Abstract
OBJECTIVE This study examined the effect of vitamin D supplementation, sunlight radiationradiation, and home isolation during the COVID-19 pandemic on the seasonal changes in 25(OH)D concentration and selected biomarkers in young soccer players along a one-year training cycle. METHOD Forty elite young soccer players (age: 17.2 ± 1.16 years, body mass: 70.2 ± 5.84, and body height: 179.1 ± 4.26 cm) participated in the research. Only 24 players completed the measurements during all four time- points (T1-: September 2019, T2-: December 2019, T3-: May 2020, and T4-: August 2020) and were divided into two subgroups: supplemented group (GS) and placebo group (GP). Players from GS received 5,000 IU of vitamin D for 8 weeks (January-MarchJanuary-March 2020). Several biomarkers such as 25(OH)D, white blood cells (WBC), red blood cells (RBC), hemoglobin (HGB), muscle damage markersmarkers, and lipid profile were measured. RESULTS AnalysisThe analysis of the total group demonstrated significant seasonal changes in 25(OH)D, HGB, asparagine aminotransferaseaminotransferase, and creatine kinase along the one1-year training cycle. The level of 25(OH)D concentrationinconcentration in T4 was significantly (p < 0.001, pη [ = 0.82) higher in both subgroups in comparison to T2 and T3. Moreover, the significant (p = 0.023) but poor (r = -0.23) correlation between 25(OH)D and WBC was calculated. CONCLUSION Current research confirmed the significant seasonal changes in 25(OH)D concentration during four seasons. 8-weekEight-week vitamin D supplementation had no extended effect on the level of 25(OH)D concentration.
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Effects of repeated use of a commercial topical lotion on subcutaneous fat thickness in resistance-trained male athletes.
Peos, JJ, Ong, J
Journal of cosmetic dermatology. 2023;(1):255-261
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Abstract
This study tested whether subcutaneous fat loss is enhanced via application of a popular topical fat loss lotion. Twenty resistance-trained men (mean ± SD age of 26.3 ± 6.3 years and weight of 86.8 ± 11.1 kg) had a topical fat-loss lotion containing Coleus forskholii, Silybin, Eucommia ulmoides leaf, Paullinia cupana seed, caffeine, and black pepper essential oil applied twice daily for 8 weeks to the front and lateral thigh of one of the participant's leg, and a placebo control lotion was applied to the same sites on the other leg. After 8 weeks, there were no significant differences between the placebo and treatment legs for the change in subcutaneous fat thickness of the front thigh (p = 0.73) or for leg fat percentage (p = 0.52). However, there was a slight, yet significant difference in the change in subcutaneous fat thickness of the lateral thigh favoring the treatment leg (-0.42 vs +0.75 mm, p = 0.029), but with this difference disappearing depending on the statistical tests being used. Only 2/19 participants perceived a difference in fat loss in response to each condition. Although the topical lotion tested here resulted in statistically significantly greater subcutaneous fat loss at the lateral but not front thigh, this effect was very small, contingent upon the statistical test being used, and unperceivable by the participants themselves.
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Human Tear Protein Analysis Using a Quantitative Microfluidic System: A Pilot Study.
Casemore, RK, Wolffsohn, JS, Dutta, D
Eye & contact lens. 2023;(11):498-504
Abstract
OBJECTIVES Human tears have the potential to be used as biomarkers to aid in the diagnosis and management of dry eye disease (DED). This prospective, controlled pilot study aimed to investigate the hypothesis that a panel of tear protein profiles can be detected and are repeatable when analyzed using a miniaturized quantitative microfluidic system. METHODS Ten participants were recruited following institutional ethics committee approval. Participants attended two visits 1 week apart when the following measurements were taken in a sequence: tear meniscus height, noninvasive breakup time, ocular redness, tear collection, and corneal and conjunctival staining. Basal tears (>4 µL) were collected using glass microcapillary tubes. Tears were processed to analyze a panel of proteins (14-230 kDa) following the manufacturer's guidelines using a miniaturized quantitative microfluidic system (Protein 230 LabChip with Agilent 2100 Bioanalyzer). Demographics of the clinical measurements and a comparison of the panel of identified proteins and their repeatability were made. RESULTS Mean age of the participants was 20.8±1.6 years, nine were females, three fulfilled the TFOS DEWS-II diagnostic criteria for DED. The total protein concentration across participants was 6.72±3.56 mg/mL. Several proteins (lysozyme C, lipocalin 1, IgA light chain, zinc-α2-glycoprotein, albumin, and lactoferrin) were identified at both visits for seven or more participants. There were no significant differences ( P >0.05) in individual protein concentrations between the two visits. A high correlation was found between the two visits for all proteins where correlation coefficient ranged between 0.63 and 0.98 ( P <0.05). CONCLUSION The protein profiles measured by the quantitative microfluidic system are repeatable, thus validating quantitative microfluidic system as a reliable method for investigating a panel of tear proteins. This method is quick, affordable, requires only 4 μL of tear, and is relatively easy method to perform that can be incorporated in a clinical setting. Further studies in larger clinical setting may be beneficial exploring the usability of this method in various patient groups.